Pregnant 15 y/o in School

[MisRN]

So I can't say that I'm exactly new to school nursing because this is my 3rd school year, but I've been doing it with very little guidance. I am the only nurse at an independent school with student from 3 years old to HS seniors. Typically I try to emulate what the public schools are doing, utilize best practices, stay within scope of practice etc....

Here's my question.... I have a 15 year old student who advised me the other day she just found out she is pregnant. Before confiding in me, she asked if I have to grant her confidentiality, which I told her yes (with some exceptions, but in this case, yes). In talking to her, I found out she also told her 4 or 5 "best friends" and 2 of her teachers, and a former teacher here from elementary grades. (So much for confidentiality!). She has since spoke to our school counselors at my advice. Now the Head of Upper School has requested a meeting with myself, the counselors and the Dean of Students in regards to how to handle the situation (future and current). I'm sure they're concerned how this will affect the other students as well. What do I need to be aware of and careful of during this meeting? I feel like I don't need to tell them any information that pertains to her specifically, but they already know. It's my understanding that the teachers and administrators would probably have called her parents & told them, but I'm not sure if that's happened.

When I worked in the Emergency Department previously, a pregnant minor can consent to care and treatment pertaining to her pregnancy without adult guardian, but not for things not related to her pregnancy.

Thanks for any input, information, advice, warnings, etc....

[OldDude]

See what I mean? There's no way you could get this much wisdom and experience from any other single source! You guys are the best!

[aprilmoss]

I see by the term "upper school" you're probably a private (and perhaps religious) school?

We don't do anything with the administration to "handle" pregnant students. I've had very few ones that actually made it to term (I did not inquire as to whether the others were false positives or aborted, not my business). All the counsellor and I do are be supportive. The two girls I've had were given blanket passes to come see me for whatever reason. The counsellor just checked to see if there was any accomodation needed in their studies. The administration other than that should butt out.

[MisRN]

I agree! I've been stalking these boards when I have questions for the first two years as a school nurse & I think this is an invaluable source of wisdom!

[MisRN]

Yep, this is one of the issues... She says her period is 2.5 weeks late. She says she took a pregnancy test at home. She says it was positive. She also says she wants to take a second one to confirm it. She has no money to buy another. She has no transportation of her own (she's 15) to get to the Health Department. She has no family in the area other than her dad, whom she's not ready to tell until she gets that 2nd pregnancy test.

I'm not sure what the administration are worried about. Possibly all the drama that goes along with 15 year old girls?

We are a private independent school so we don't have district policies to refer to.

[MisRN]

I would not want to be the one who is singled out for passing information, authorized or not. Why is a meeting necessary anyway? The school has never dealt with pregnant students before? Say as close to nothing as possible while taking in what the meeting is truly about.

We are a small college-preparatory school with an enrollment of 350 students (PK- 12th grades). I heard that once long before my time, there had been a student who got pregnant, finished that school year, delivered over the summer, and did not re-enroll the following year. I think it's fair to say, we've not dealt with pregnant students before, at least not under the current administration.

[JenTheSchoolRN, BSN, RN]

Yep, this is one of the issues... She says her period is 2.5 weeks late. She says she took a pregnancy test at home. She says it was positive. She also says she wants to take a second one to confirm it. She has no money to buy another. She has no transportation of her own (she's 15) to get to the Health Department. She has no family in the area other than her dad, whom she's not ready to tell until she gets that 2nd pregnancy test.

I'm not sure what the administration are worried about. Possibly all the drama that goes along with 15 year old girls?

We are a private independent school so we don't have district policies to refer to.

I've have a couple of tests on stock in my office - yep, they do get used. And I also have cards to refer students to a local teen-only clinic for sexual health run by one the larger community health centers in my area; they can do the pregnancy test again there for free. Do you know of any resources in your area, OP?

[peacockblue]

We do not stock pregnancy tests. I would not provide any diagnostic test to a minor. I refer them to dollar general or the like because they are cheap and as reliable as the name brand ones. I agree with those above that say make sure she is pregnant before you do anything. I have actually had a student put a fake sonogram picture on Facebook. My thing is to STRONGLY encourage the student tell the parent. If they are choosing to terminate and have the resources to do that, the parent may never know but if they are parenting or adopting, the parent will know sooner or later. I always tell the student if they are afraid to tell, we can always call the parent in for a meeting and she can tell them with myself and a counselor present to help diffuse the situation. We don't really provide accommodations such as no stairs or PE. I worked as a med surg nurse till delivery. I know these girls are young, but they need to move and do what they normally would. Pregnancy is a normal state. Usually the physician will write no contact sports. I have had girls eat lunch in my office or guidance because the smells of the cafeteria are too overwhelming. Also, if they are really queasy in the morning, they can lay down in my office if that's what gets them through the day. If she is pregnant and is going to carry to term, she will need a lot of support. Remind her to hold her head up and ignore those who give her a hard time. Provide her with a space that is non judge mental. And hook her up with all your local resources. CHIP, WIC and whatever else you have. I don't love that my young girls get pregnant but I find it very rewarding to support them and encourage them to continue in school to be the best moms they can.

[MisRN]

Just an update on this situation....

First I want to say a huge THANK YOU!!! to all the contributors on this thread and the advice, insight, and information shared! It truly is invaluable!

So here's what happened at the meeting.... They came up with a plan on how the teachers should respond when this student was sharing her news with them, which was to refer her to talk to the school counselor and/or me (the school nurse).

The administration seemed very intent on getting the student to talk to her dad (whom she lives with) to inform him, almost to the point of pressuring her. I basically told them that this issue is a private medical condition and that really it's up to her and not our business. They seemed to want to use the crutch of "but she's in crisis" in order to push her to tell her dad, to which I reminded them pregnancy is normal. It was because of posts on this thread that I was able to stand up for her and her rights, and not get sucked into the drama.

It ended up that she finally was able to take s 2nd test, which was negative. Yay! Now it's a non-issue!

Thanks again everyone!

[NutmeggeRN, BSN]

It ended up that she finally was able to take s 2nd test, which was negative. Yay! Now it's a non-issue!

Thanks again everyone!

This is my surprised face...

[SiwanRN]

Hooray for it being a non-issue! But if any school nurses out there run into a situation like this again in the future, please do not hesitate to call your local health department family planning clinic. The public health nurses there (like me) would be more than happy to field a call from a school nurse to at least provide you with a list of resources (for all options of pregnancy outcomes) that you can then share with your pregnant/parenting students, even if the student was not able to make it to the clinic herself for a pregnancy test appointment.